MEDICARE: ELEGED HOME CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1578081386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEGED HOME CARE INC

Provider Business Mailing Address
First Line	:	3101 E FRANKLIN AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-1132
Country	:	US
Telephone Number	:	612-315-4497
Fax Number	:	612-435-2770

Provider Business Practice Location Address
First Line	:	3101 E FRANKLIN AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-1132
Country	:	US
Telephone Number	:	612-315-4497
Fax Number	:	612-435-2770

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ABDI ALI
Credential	:
Telephone Number	:	612-315-4497

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	03/04/2026

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